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Why doctors still need to supervise nurse anesthetists

In his column supporting HB 607, Florida Association of Nurse Anesthetists President Jose Delfin D. Castillo III repeats many talking points that have been used to justify this dangerous proposal since the legislative session began. Allowing advanced practice registered nurses (APRNs) and physician assistants to practice beyond the scope of their training and with no physician supervision would expose Florida’s patients to unnecessary risk, while compromising the standard of care. The numbers speak for themselves: After completing four years of medical school, physicians receive at least 15,000 clinical training hours in post-graduate residency programs lasting three to seven years. By comparison, APRNs spend 1.5 to three years in nursing programs, are not required to undergo any post-graduate training and obtain only 500 to 1,500 clinical training hours.

Despite the writer’s assertion that physician supervision rules are “antiquated,” they are the norm. As Census data shows, states that do not allow APRNs to practice autonomously represent about 70 percent of the country’s population. Studies also cast serious doubt on the argument that HB 607 would help control health-care costs. For example, a Mayo Clinic study revealed that inappropriate patient referrals by APRNs and physician assistants could offset any potential savings from expanding their use. A JAMA Internal Medicine study found that, compared to primary care doctors, APRNs and PAs were associated with increased ordering of diagnostic imaging.

HB 607 poses a threat to vulnerable patients, which is why the Florida Medical Association and more than 50 other medical professional societies formed the Florida Patient Protection Coalition, aiming to educate the public about the benefits of physician-led, team-based care, while combating the narrative being spun by HB 607’s supporters. We urge lawmakers to put Floridians’ well-being above rhetoric.

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